Thursday, April 9, 2009

Time to change things up

After hearing back from the powers that be at Duke Pediatric GI....here's what we are gonna try...

We are going to start making Riley's bottles at 24kcal per ounce (otherwise known as 24kcal/oz). How do we do that? Well...let me tell you...typically, to make powdered formula up in the standard way, you use one full,level scoop for every 2oz of water. So...Riley eats 6oz bottles, so we put 6oz of water and 3 scoops of formula in every bottle. That makes 20kcal/oz formula. But this isn't enough nutrition for Riley. He takes in the amount (or volume) of formula he needs to per day.His body just needs extra calories because it has to work so much harder at things like digestion. Compare this to swimmer Michael Phelps consuming 10,000 calories per day because his energy needs are so high. Well....Riley, due to his former health issues, and ongoing digestive issues, needs more calories per ounce than what is typical in order to gain weight effectively. However, the potential problems with doing this are: 1) it will be too concentrated for his system, give him diaherrea which is always a HUGE concern for him, and just overall not tolerate this change or 2)it will be more filling to him and won't take in the same volume so effectively, he'll be consuming the same number of calories per day,and not be getting the extra. What??? Well.... (and yes, I'm bored or I wouldn't have the patience for this math), here is how that scenario plays out. Right now Riley eats 6 oz of 20kcal/oz formula, 5 times per day. SO...6 times 20=120kcal's per feed times 5 feeds a day = 600kcal per day.

So now, we are upping to 24kcal/oz. IF he will still consume 6oz per feed at 5 feeds per day....6x24=144 x 5=720kcal per day. That should add some chub to him. BUT if its too rich, and he won't eat 6oz per bottle...lets say he'll only eat 5oz per bottle....5x24=120kcal per feed. So...we'd be no better off than we are right now, because 120kcal per feed x 5 feeds a day = 600kcal per day, just like he's getting right now.

Shew! Too much math!

But that isn't the only changes....he's starting that tonight(the formula change)...if he tolerates that ok between tonight and Sunday evening, we can add either green beans or carrots to his diet in addition to the rice cereal he's getting now. BIG BOY!!! Why one of those? They are low in sugar. Higher sugar (as in the higher concentrated formula) makes the liklihood of too much output more likely.

That enough talk about poop for your day?

OH, at Riley's dr appointment earlier today...Travis took all the notes of the measurements for Jay so they could remember them to share with me. What a good boy he is!

And soda can pop tops....if you would like to collect them or you have been collecting them for the RMH of Durham, we would be glad to deliver them, just get them to us directly or by route of someone that knows us. We go up to Durham twice a month, so it's easily do-able for us. And we will be forever grateful that you supported the RMH.

Oh I almost forgot,how do you make 24kcal/oz formula?? You put 5 (yes FIVE) level/packed scoops of formula into 8oz of water. I think I'm gonna look into ordering his formula by the case.Cause those little cans are gonna run dry about every other day.

I go home tomorrow from my training, so should be some pictures sometime after that (cause I know that is what you all really want).

Lindsey, I surely hope all of the changes agree with little Riley's tummy and intestines. I must say, you have much more patience with numbers, then I would have. Good Job!Just hope Riley doesn't decide to do the "rasberries" with a mouth full of beans or carrots! Sounds like it may be time for longer bibs! Good Luck with the new feedings, and putting some fat on that precious boy.Love and Hugs, Dale

Welcome to the 24 kcal club! :) You will go through more formula than you ever thought possible. Carter, who you know doesn't tolerate much as far as GI goes, tolerates 24 kcal very well. Also keep in mind that the rice cereal adds cals. They told us that 1 tsp./oz adds 2 cals/oz. That seems a little high to me, but I'm not the expert.

You might already know about these, but one of the diaper companies makes disposable bibs with a pouch at the bottem. We love them b/c you just toss when they are done. Might be something to look into now that you are venturing into "real" food.

Congrats on getting the thumbs up for real food. I can't wait for that day. So far, we're still stuck in formula land.

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Travis

Travis is 10 years old. He loves baseball, basketball, cub scouts, riding 4-wheelers, fishing, wakeboarding and boats. Make that, he is OBSESSED with boats! He is a good student, and is very compassionate and loving. He is very creative, and loves to make inventions. He is a born athlete, and running is his newest love. He is a super big brother! He is my firstborn, and I love him more than words. He is often called Trav, and TBird.

Riley

Riley is 4 years old. He was born at exactly 37 weeks. At 4 days old, he was diagnosed with Necrotizing Enterocolitis (NEC). He spent 107 days in the NICU, and there were several times, that we were unsure if he would survive. But survive he did, and 5 intestinal surgeries later, he is a happy, HEALTHY 4 year old, with very few issues as a result of his ordeal, eventhough he is medically considered to be "short gut". He loves trains, trucks, playing outside, tubing behind the boat in the summer and idolizes his big brother. He calls Travis Trav, and wherever Trav is, is where Riley wants to be. He is often called Riley Bear.